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Case Reports
. 2018 May 21:2018:7231326.
doi: 10.1155/2018/7231326. eCollection 2018.

The Heart as a Site of Metastasis of Benign Metastasizing Leiomyoma: Case Report and Review of the Literature

Mariam Meddeb  1 , Robert D Chow  1 , Randolph Whipps  1 , Reyaz Haque  1
Affiliations
Case Reports

The Heart as a Site of Metastasis of Benign Metastasizing Leiomyoma: Case Report and Review of the Literature

Mariam Meddeb et al. Case Rep Cardiol. .

Abstract

Uterine leiomyomas are the most common gynecological tumors in premenopausal women. While the lung is the most common extrauterine organ afflicted, benign metastasizing leiomyomas (BML) of the heart are rarities. We report an incidental finding of a cardiac mass in a 36-year-old woman who presented to the Emergency Department after a motor vehicle accident. CT scan of the chest revealed 2 well-circumscribed pulmonary nodules and a filling defect in the right ventricle. Echocardiogram showed a 4 cm mass attached to the right ventricular (RV) septum. The cardiac tumor was resected and showed benign histologic features. Immunohistochemical staining was positive for smooth muscle α-actin and desmin, as well as estrogen and progesterone receptors, consistent with the diagnosis of uterine leiomyoma.

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Figures

Figure 1
Figure 1
Chest CT scan with IV contrast showing a filling defect within the contrast-enhanced right ventricle which was initially thought to be a large thrombus extending to the right ventricular outflow tract.
Figure 2
Figure 2
Cardiac magnetic resonance imaging showing an oblong soft tissue mass abutting the pulmonary valve.
Figure 3
Figure 3
Surgical specimen consisting of a 12-gram pink-tan rubbery mass that is 4.7 × 2.6 × 2.1 cm. A scant amount of red-tan, shaggy adherent tissue is present on one edge representing the papillary muscle penetrated by the tumor. The sacrificed chordae tendinae traversing the lesion can also be seen on the other edge.
See this image and copyright information in PMC

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